State of Illinois
91st General Assembly

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 1        AN  ACT  to amend the Health Maintenance Organization Act
 2    by changing Section 2-5.

 3        Be it enacted by the People of  the  State  of  Illinois,
 4    represented in the General Assembly:

 5        Section  5.   The  Health Maintenance Organization Act is
 6    amended by changing Section 2-5 as follows:

 7        (215 ILCS 125/2-5) (from Ch. 111 1/2, par. 1406.1)
 8        Sec.  2-5.    Claims   Liabilities.    A   Every   Health
 9    Maintenance   Organization  shall,  at  all  times,  maintain
10    liabilities in  an  amount  estimated  in  the  aggregate  to
11    provide  for  the  payment of all claims incurred and any due
12    and  unpaid  provider   capitation,   whether   reported   or
13    unreported,  which are unpaid and for which such organization
14    is or may be liable,  and  to  provide  for  the  expense  of
15    adjustment  or  settlement  of such claims.  Such liabilities
16    shall be computed in accordance with regulations  promulgated
17    by   the   Director  upon  reasonable  consideration  of  the
18    ascertained experience and character of such business for the
19    purpose of adequately protecting enrollees and  securing  the
20    solvency of such organizations.
21        Whenever  the  claim  and claim expense experience of any
22    such  organization  shows  the  liabilities   calculated   in
23    accordance  with  such  regulations  to  be  inadequate,  the
24    Director may require such organization to maintain additional
25    liabilities.
26    (Source: P.A. 86-620.)

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